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The contractual limit of 72 hours worked within any consecutive seven-day period is breached

The minimum of an 11-hour rest between shifts is reduced to less than eight hours

Meal breaks are missed on more than 25 per cent of occasions

When any of these instances occur, the junior doctors get a choice of extra pay or further time off aside from their contracted leave.

The trust, which runs Croydon University Hospital, says that the fines were incurred due to it not being able to give the junior doctors time off in lieu because it was understaffed.

Dr Nnenna Osuji, medical director at Croydon Health Services NHS Trust, said: “Along with other trusts, we have initially found it difficult for trainees to take time off in lieu as the trust was not prepared to compromise patient safety by running with understaffed medical teams, so we decided to opt for payment instead.”

Exception reporting, the process of declaring unsafe working hours, only applies to trainee doctors on the NHS’ new 2016 contracts.

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During this period concerns were raised due to paediatrics and neonatology trainees being scheduled to work six 13-hour shifts in a seven-day period, totalling 78 hours of work in a week.

A report compiled for the trust's board said, in relation to the overworking: “The safety of patients is a paramount concern for the NHS. Significant staff fatigue is a hazard both to patients and to the staff themselves.”

A portion of the money incurred from the fines is put into a fund which is then used to subsidise F1 junior doctors - who are trainees on the lowest grade of pay - to attend a life-support course or take part in a post-graduate exam.

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In response to the amount of fines given to the trust it has decided to employ short-term locums (temporary doctors who step in) to allow trainees to take time off when it is needed.

It has also decided to alter the shift patterns of trainees in certain departments and to allow surgical teams at F1 grade to provide cross cover in other departments to allow trainees to take time off.

Dr Osuji said: “Since October we have recruited four physician associates to work in general medicine and are committed to reducing the number of exception reports and allowing junior doctors time off in lieu to ensure that our hard-working doctors get adequate rest and maintain patient safety.”